Individual provider Active NPI

Michael Tanlioco, PHYSICAL THERAPIST

  • Physical Therapist
  • South Richmond Hill, NY
National Provider Identifier
1659568194
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018568-1 Issued in NY
Practice address
11203 Liberty Ave
South Richmond Hill, NY 11419-1813
Phone
(718) 641-1212
Fax
(718) 845-4010
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 018568-1 NY Primary

Addresses

Primary practice location

11203 Liberty Ave
South Richmond Hill, NY 11419-1813

Mailing address

1991 Marcus Ave
Ste 110
New Hyde Park, NY 11042-2062
Phone (917) 940-8615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201104000580 NY Practitioner - Physical Therapist in Private Practice 2769892637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurological Associates of Long Island, PCGroup PAC ID 9234028788, 14 clinicians

Practice addresses (Care Compare)

1991 Marcus Ave
Suite 110
New Hyde Park, NY 11042-2062
Phone 5164664700110

Merit-based Incentive Payment System (MIPS)

Final score
84.68 of 100Reported as group
Quality
72.69
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018568-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Associates of Long Island, PC CurrentSince Oct 1, 2020 Accepting new patients
Priority One Therapy PT OT SLP PLLC CurrentSince Jul 8, 2024 Accepting new patients
Queens General Medical PC Past Accepting new patients

Locations

1991 Marcus Ave
Ste 110
New Hyde Park, NY 11042
Phone (516) 365-8086

99 W Hawthorne Ave
Ste 210
Valley Stream, NY 11580
Phone (718) 305-1190

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1659568194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "STE 110",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422062",
            "telephone_number": "917-940-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11203 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191813",
            "telephone_number": "718-641-1212",
            "fax_number": "718-845-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANLIOCO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018568-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.